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Care of the Elderly.

Dáil Éireann Debate, Tuesday - 17 February 2004

Tuesday, 17 February 2004

Ceisteanna (274)

Richard Bruton

Ceist:

360 Mr. R. Bruton asked the Minister for Health and Children if his attention has been drawn to the lack of publicly funded convalescent beds for persons who have completed a period of acute care in the hospital system; if he has carried out an assessment of the number of convalescent beds required per acute bed in the system to provide an effective step-down care facility; the findings of this study; and if he will make a statement on the matter. [4534/04]

Amharc ar fhreagra

Freagraí scríofa

The policy of my Department regarding the care of older people is to maintain them in dignity and independence in their own home for as long as possible in accordance with their wishes. This policy was first enunciated in the care of the aged report, published in 1968, and confirmed in the report, The Years Ahead: A Policy for the Elderly, published in 1988. Numerous research studies have shown that the vast majority of older people has a preference to remain living in their own home for as long as possible rather than moving into long-stay residential care.

Since my appointment as Minister of State, I have encouraged the authority and the health boards to introduce personal care packages for older people as an alternative to long-stay residential care. Personal care packages are specifically designed for the individual concerned and could possibly include the provision of a home help service, home subvention payments, arrangements for attendance at a day centre or day hospital and other services such as twilight nursing. Personal care packages allow older persons the option of remaining living in their own home rather than going into long-stay residential care.

The report, Acute Hospital Bed Capacity — A National Review, sets out the need to develop additional capacity in the acute hospital system and the Government decided, in the context of the health strategy, Quality and Fairness — A Health System for You, to develop an additional 3,000 beds in the acute hospital system by 2011. There is also a commitment in the national health strategy to provide 1,370 additional assessment and rehabilitation beds, plus 600 additional day hospital places for older people encompassing specialist areas such as falls, osteoporosis treatment, fracture prevention, Parkinson's disease, stroke prevention, heart failure and continence promotion clinics. In addition, the strategy proposes the provision of an extra 5,600 extended care-community nursing unit places over seven years, which will include provision for people with dementia.

As the Deputy may be aware, public private partnerships are being piloted in the health sector. PPP is based on the concept that better value for money for the Exchequer may be achieved through the exploitation of private sector competencies to capture innovation and the allocation of risk to the party best able to manage it. Initially, the focus will be mainly in the area of community nursing units for older people. It is anticipated that 17 new community nursing units will be created when the initial pilot programmes are complete, providing up to a maximum of 850 new beds in Dublin and Cork. The services offered in these units will include: assessment-rehabilitation, respite, extended care and convalescence. If the PPP pilots demonstrate success, it is the intention to use PPP as a means of providing additional community nursing units in other locations throughout the country.

In addition, under the acute hospital bed capacity initiative, my Department has provided an additional €8.8 million to the Eastern Regional Health Authority and €3.8 million to the Southern Health Board to facilitate the discharge of patients from the acute system to a more appropriate setting, thereby, freeing up acute hospital beds. My Department has been informed by the authority that in excess of 200 patients in the acute hospital system in the eastern region have been moved to more appropriate accommodation in the private nursing home sector under this initiative.

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